Testoni Ines, Brondolo Elizabeth, Ronconi Lucia, Petrini Flavia, Navalesi Paolo, Antonellini Marco, Biancalani Gianmarco, Crupi Robert, Capozza Dora
Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova.
Department of Psychology, St. John's University.
Psychol Trauma. 2023 Sep;15(Suppl 2):S357-S370. doi: 10.1037/tra0001346. Epub 2022 Aug 4.
Italy was the first country outside Asia to deal with the early phase of the COVID-19 pandemic, and health care facilities and medical staff were not fully prepared. Research worldwide has documented the enormous effect of the COVID-19 pandemic on health care providers' mental health, including experiences of dehumanization, but less work has focused on factors which may influence the development of these outcomes in response to COVID-19-related stress.
This study examined the association of dehumanization, self-efficacy, and alienation to burnout, depression, and PTSD among medical staff. Potential moderators included moral injury, professional role, COVID workload, and work in a critical care unit (CCU).
Participants were recruited through the Internet. The sample consisted of 270 medical staff members who completed a self-report survey online. Instruments included: Human Traits Attribution Scale for dehumanization; NYP-Queens Survey-Self-Efficacy Subscale for self-efficacy; Moral Injury Events Scale for moral injury; Alienation Scale for alienation; PTSD-8 for posttraumatic stress disorder; Patient Health Questionnaire-9 for depression; and a single item for burnout. The analytic plan included ANOVAs, zero-order correlations, logistic regression analyses, multiple linear regression models, and parallel mediation.
Results show that dehumanization was associated with higher levels of burnout, PTSD, and depressive symptoms and effects were consistent across professional role and work context. Dehumanization was significantly associated with PTSD symptoms only among those who had increased COVID-19-related caseloads. Moral injury was positively associated with dehumanization, displayed an independent association with all 3 mental health outcomes, over and above dehumanization, and tended to exacerbate the effects of dehumanization. The effect sizes across analyses were small to medium.
This research confirms that the COVID-19 pandemic stressed Italian medical staff in a way not documented in the prepandemic literature. There is a need to support staff in their complex relationships and communication with patients. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
意大利是亚洲以外首个应对新冠疫情早期阶段的国家，医疗保健机构和医护人员并未做好充分准备。全球范围内的研究记录了新冠疫情对医护人员心理健康的巨大影响，包括被剥夺人性的经历，但较少有研究关注可能影响这些因应对新冠相关压力而产生的结果的因素。
本研究考察了医护人员中被剥夺人性、自我效能感和疏离感与职业倦怠、抑郁和创伤后应激障碍之间的关联。潜在的调节因素包括道德伤害、职业角色、新冠疫情期间的工作量以及在重症监护病房（CCU）工作。
通过互联网招募参与者。样本包括270名通过在线方式完成自我报告调查的医护人员。所使用的量表包括：用于测量被剥夺人性的人类特质归因量表；用于测量自我效能感的纽约长老会皇后区自我效能感量表；用于测量道德伤害的道德伤害事件量表；用于测量疏离感的疏离感量表；用于测量创伤后应激障碍的创伤后应激障碍-8量表；用于测量抑郁的患者健康问卷-9量表；以及一个用于测量职业倦怠的单项量表。分析计划包括方差分析、零阶相关分析、逻辑回归分析、多元线性回归模型和平行中介分析。
结果表明，被剥夺人性与更高水平的职业倦怠、创伤后应激障碍和抑郁症状相关，且这种影响在不同职业角色和工作环境中是一致的。仅在那些新冠相关病例数量增加的人群中，被剥夺人性与创伤后应激障碍症状显著相关。道德伤害与被剥夺人性呈正相关，除被剥夺人性外，与所有三种心理健康结果均呈现独立关联，且往往会加剧被剥夺人性的影响。各分析中的效应量为小到中等。
本研究证实，新冠疫情给意大利医护人员带来的压力在疫情前的文献中未曾有过记载。需要支持医护人员处理与患者之间复杂的关系和沟通。（《心理学文摘数据库记录》（c）2023美国心理学会，保留所有权利）
